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Spencer, Stephen 
ORCID: https://orcid.org/0000-0001-8451-7514, Malowa, Florence, McCarty, David, Joekes, Elizabeth, Phulusa, Jacob, Chinoko, Beatrice, Kaimba, Sylvester, Keyala, Lucy, Mandala, Peter, Mkandawire, Mercy, Mlongoti, Matthew, Mnesa, Bright, Mukatipa, Albert, Mijumbi, Rhona, Nyirenda, Mulinda, Sawe, Hendry, Henrion, Marc, Augustine, Daniel, Oxborough, David, Worrall, Eve ORCID: https://orcid.org/0000-0001-9147-3388, Limbani, Felix, Dark, Paul, Gordon, Stephen, Rylance, Jamie ORCID: https://orcid.org/0000-0002-2323-3611 and Morton, Ben ORCID: https://orcid.org/0000-0002-6164-2854
(2024)
'Causes, outcomes and diagnosis of acute breathlessness hospital admissions in Malawi: protocol for a multicentre prospective cohort study'. Wellcome Open Research, Vol 9, e205.
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Spencer et al 2024_Breathlessness causes outcomes and diatnosis protocol_wellcomeopenres.pdf - Published Version Available under License Creative Commons Attribution. Download (1MB) | Preview |
Abstract
Background
Hospital admission due to breathlessness carries a significant burden to patients and healthcare systems, particularly impacting people in low-income countries. Prompt appropriate treatment is vital to improve outcomes, but this relies on accurate diagnostic tests which are of limited availability in resource-constrained settings. We will provide an accurate description of acute breathlessness presentations in a multicentre prospective cohort study in Malawi, a low resource setting in Southern Africa, and explore approaches to strengthen diagnostic capacity.
Objectives
Primary objective: Delineate between causes of breathlessness among adults admitted to hospital in Malawi and report disease prevalence. Secondary objectives: Determine patient outcomes, including mortality and hospital readmission 90 days after admission; determine the diagnostic accuracy of biomarkers to differentiate between heart failure and respiratory infections (such as pneumonia) including brain natriuretic peptides, procalcitonin and C-reactive protein.
Methods
This is a prospective longitudinal cohort study of adults (≥18 years) admitted to hospital with breathlessness across two hospitals: 1) Queen Elizabeth Central Hospital, Blantyre, Malawi; 2) Chiradzulu District Hospital, Chiradzulu, Malawi. Patients will be consecutively recruited within 24 hours of emergency presentation and followed-up until 90 days from hospital admission. We will conduct enhanced diagnostic tests with robust quality assurance and quality control to determine estimates of disease pathology. Diagnostic case definitions were selected following a systematic literature search.
Discussion
This study will provide detailed epidemiological description of adult hospital admissions due to breathlessness in low-income settings, which is currently poorly understood. We will delineate between causes using established case definitions and conduct nested diagnostic evaluation. The results have the potential to facilitate development of interventions targeted to strengthen diagnostic capacity, enable prompt and appropriate treatment, and ultimately improve both patient care and outcomes.
| Item Type: | Article |
|---|---|
| Subjects: | WA Public Health > WA 30 Socioeconomic factors in public health (General) WF Respiratory System > WF 20 Research (General) WG Cardiovascular System > WG 20 Research (General) |
| Faculty: Department: | Clinical Sciences & International Health > Clinical Sciences Department |
| Digital Object Identifer (DOI): | https://doi.org/10.12688/wellcomeopenres.21041.1 |
| Depositing User: | Amy Smith |
| Date Deposited: | 14 May 2024 13:45 |
| Last Modified: | 14 May 2024 13:45 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/24529 |
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